Individual
PETER RIVERA FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1621 E VINE ST, KISSIMMEE, FL 34744-3730
(407) 847-4152
Mailing address
1621 E VINE ST, KISSIMMEE, FL 34744-3730
(407) 847-4152
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/09/2021
Last updated
03/09/2021
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